OAR 409-065-0025
Compliance and Enforcement

(1) Unless approved by a waiver or exception, failure to comply with general data submission requirements includes but is not limited to:
(a) Failure to submit data files by the specified submission date;
(b) Failure to submit data files for a required line of business.
(2) Unless approved by a waiver or exception, failure to comply with data file requirements includes but is not limited to:
(a) Submitting a data file in an unapproved layout;
(b) Submitting a data element in an unapproved format;
(c) Submitting a data element with unapproved coding;
(d) Failure to submit a required data element; or
(e) Failure to comply with validation and quality control efforts, including resubmitting or correcting data as requested by the Authority.
(3) The Authority must provide mandatory reporters written notification of each failure to comply with data submission requirements prior to imposing a civil penalty. Mandatory reporters will have 30 calendar days from notification to come into compliance.
(4) The Authority may impose civil penalties against mandatory reporters for each failure to comply that is not resolved within 30 calendar days of written notification. If a mandatory reporter does not come into compliance within 30 calendar days of written notification, penalties may be assessed starting from the date the mandatory reporter was notified of non-compliance. Pursuant to ORS 442.993 (Civil penalties for failure to report health care data of health insurers), the Authority may adopt a schedule of civil penalties not to exceed $500 per day of violation, determined by the severity of the violation for any mandatory reporter that fails to report cost growth data.
(5) If a mandatory reporter has made documented efforts to comply with these rules, the Authority may consider this a mitigating factor before imposing civil penalties against the mandatory reporter.

Source: Rule 409-065-0025 — Compliance and Enforcement, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=409-065-0025.

Last Updated

Jun. 8, 2021

Rule 409-065-0025’s source at or​.us